Wide excision with clitovulvopexy for the treatment of chronic vulvar pruritus: A new surgical technique

OBJECTIVE: Chronic vulvar irritation and pruritus are among the most common reasons for gynecologic consultation. These symptoms often persist or recur, posing a significant therapeutic challenge. This preliminary study aimed to evaluate the effectiveness and cosmetic outcomes of a novel surgical technique we developed. MATERIALS AND METHODS: We developed a novel surgical technique, wide excision with clitovulvopexy, as a treatment for chronic vulvar pruritus. This technique, not previously described in the English literature, involves the complete excision of all diseased vulvar skin, including the clitoral prepuce and labia minora. The impact on sexual function and sensation was assessed. Cosmetic outcomes were evaluated by patients using a four-point satisfaction scale: very satisfied (score 4), moderately satisfied (score 3), minimally satisfied (score 2), and unsatisfied (score 1). RESULTS: The median operative time was 30 min, with minimal blood loss in all cases. No intraoperative or postoperative complications were observed. Vulvar irritation and pruritus resolved completely in all patients, with no recurrence during the follow-up period. Among the nine patients, three reported an improvement in sexual function, while five maintained their preoperative levels without deterioration. Sensation was well preserved in all patients. Eight out of nine patients (88.9%) reported being very or moderately satisfied with their cosmetic outcomes. CONCLUSION: The findings of this preliminary study are highly promising. Wide excision with clitovulvopexy appears to be a safe and effective surgical option for treating chronic vulvar pruritus, providing excellent symptom relief and satisfactory cosmetic results in an outpatient setting.